Medizinisch klinische Diagnostik bei Schimmelpilzexposition in Innenräumen

Is in vitro cytokine release a suitable marker to improve the diagnosis of suspected mold-related respiratory symptoms? A proof-of-concept study

“…Aerosolized particles may range from cotton dust to fungal hyphae or bacterial cells, as well as their fragments or aggregates [ 24 ]. In comparison to other environmental allergens, the sensitizing potential of molds is estimated to be low, with a prevalence of sensitization of 3 – 10% reported among the total European population [ 1 ]. In addition to the IgE-mediated mechanism of sensitization, other reaction pathways in the immune system are possible that are triggered by molds.…”

“…Health effects due to mold exposure are widely discussed, especially in the field of preventive health care [ 1 ]. Fungal exposure and/or sensitization to molds has been shown to be strongly associated with the development of asthma and allergic airway diseases [ 2 , 3 ].…”

Schadstoffe im Innenraum – aktuelle Handlungsfelder

“…Bei Schimmelbefall treten nicht nur Schimmelpilze und Bakterien, sondern auch Bioaerosole mit einer Vielzahl biogener Partikel und Stoffe in der Innenraumluft auf, die zu den gesundheitlichen Beschwerden bei Schimmelbefall beitragen können. Neben Schimmelpilzen stehen im Innenraumbereich seit einigen Jahren auch zunehmend Bakterien der Klasse Actinobacteria als Auslöser gesundheitlicher Beschwerden im Fokus [51].…”

What should be tested in patients with suspected mold exposure? Usefulness of serological markers for the diagnosis

“…Regardless, the specific causes of the exposed patient’s complaints should be identified and where possible, the disease as well. Accordingly, the German guideline for clinical diagnosis of indoor mold exposure [ 7 ] recommends objectifying mold-/dampness-induced health problems, such as asthma, allergic rhinitis, hypersensitivity pneumonitis, and respiratory infections. The following aspects should be inquired about in the medical history: history of exposure in the living, working, and recreational areas; allergy and infection history, including predisposing factors; history of irritative-toxic and odor effects and disturbances in well-being.…”

“…Therefore, a quantitative mold exposure measurement is not recommended as a general strategy, although exceptions should be made in individual cases of concrete health problems and existing suspicion of causal mold exposure. It is rather recommended to consider indoor mold growth as a potential health risk, even if a quantitative and causal relationship cannot be established between the occurrence of individual species and health conditions [ 7 ]. In this respect, questionnaire-based data on dampness, moisture, and microbial exposure can be a useful and cost-effective alternative.…”